Individual
DR. THOMAS HAROLD LANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 MEDICAL PLZ STE 310, LAKE ST LOUIS, MO 63367-1484
(636) 625-2662
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2014012158
MO
208800000X
Urology Physician
35561
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3759065
AETNA
—
01
—
4057350
BCBS
—
01
—
7845411
CIGNA
TN
01
—
P00004666
RR MEDICARE
—
Enumeration date
05/24/2006
Last updated
03/07/2023
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